Risk Adjustment Auditor

Job not on LinkedIn

🔥 2 minutes ago

🦞 Maine – Remote

🦞 Maine – Remote

💵 $75.6k - $93.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🔎 Auditor

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Martin's Point Health Care

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🛡️ Insurance

📦 Logistics

💼 Consulting

Insurance • Logistics • Consulting

Martin's Point Health Care is a healthcare organization committed to serving its local communities through high-quality primary and specialty care services. The organization places a strong emphasis on creating a positive workplace culture, recognizing employee contributions, and fostering workforce diversity. Martin's Point Health Care offers a range of career opportunities across various departments, from healthcare providers to corporate roles, and supports employee growth through competitive compensation, development programs, and generous perks. Additionally, the company is recognized for its community impact efforts, raising significant funds for community organizations and encouraging employee volunteerism.

📋 Description

• Conduct coding, documentation, and validation audits of medical records and clinical data for risk adjustment vendors and other targeted universes • Review patient medical records, including physician notes, lab results, and diagnostic reports, to identify relevant diagnoses and capture essential information for accurate coding • Assign appropriate ICD-10 codes to document and accurately represent patient conditions and ensure compliance with coding guidelines and regulations • Stay updated with changes in HIPAA protocols, coding guidelines, regulations, and compliance standards • Meet team performance metrics for quantity of work completed and quality audit scores • Conduct RADV/IPM Chart Review duties as assigned • Periodically participate in the Coding Advisory Committee

🎯 Requirements

• Associate's degree or combination of relevant education and experience • 5+ years of clinical coding experience • Experience in risk adjustment coding • Certified Coder (CPC/COC) or Certified Risk Coder (CRC) required • Proficient understanding of ICD-9/10-CM, CPT, and other specialty system coding guidelines • Strong knowledge of medical terminology and chronic disease management • Strong auditing skills specific to Medicare Risk Adjustment • Excellent written and verbal communication skills • Strong problem-solving skills • Strong organizational skills • Ability to relate to different types of people and build constructive and effective relationships • Ability to work independently with minimal supervision • Position is not eligible for immigration sponsorship

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • Retirement savings with employer contributions • Paid time off • Volunteer time off • Pie day • Other employee benefits • Incentive or commission-based programs may be available, where applicable